Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Factors that can cause reluctance to attend school can be divided into four categories. These categories have been developed based on studies in the United States under the leadership of Professor Christopher Kearney. Some students may be affected by several factors at once.
- The child might want to be free.
- The child possibly wants to avoid school-related issues and situations that cause them to experience unpleasant feelings, such as anxiety, depression, or psychosomatic symptoms. The reluctance to attend school is one symptom that can indicate the presence of a larger issue, such as anxiety disorder, depression, learning disability, sleep disorder, separation anxiety or panic disorder.
- The child may want to avoid tests, presentations, group work, specific lessons, or interaction with other children. The child should be assessed for learning disabilities if academic performance is average or low.
- The child may want attention from significant people outside of school, such as parents or older acquaintances.
- The child possibly wants to do something more enjoyable outside of school, like practice hobbies, play computer games, watch movies, play with friends such as riding bikes, etc., or learn autodidactictally.
Other factors can be:
- Anxiety about academic achievement and being tested can arise on the basis of inflated claims by teachers and/or parents, but also unrealistic ambitions of the upset child themselves.
- School refusal may arise as a response to bullying or peer rejection.
- Shyness or a social phobia can contribute to school refusal.
- The child might worry about parents or siblings, for instance, a parent with substance abuse, or a parent who physically abuses other family members.
- Some students may refuse to go to school due to anxiety or fears of emergency drills, such as fire, lockdown, and tornado drills.
Specific phobias have a one-year prevalence of 8.7% in the USA with 21.9% of the cases being severe, 30.0% moderate and 48.1% mild. The usual age of onset is childhood to adolescence. Women are twice as likely to suffer from specific phobias as men.
Evolutionary psychology argues that infants or children develop specific phobias to things that could possibly harm them, so their phobias alert them to the danger.
The most common co-occurring disorder for children with a specific phobia is another anxiety disorder. Although comorbidity is frequent for children with specific phobias, it tends to be lower than for other anxiety disorders.
Onset is typically between 7 and 9 years of age. Specific phobias can occur at any age but seem to peak between 10 and 13 years of age.
Approximately 1 to 5% of school-aged children have school refusal, though it is most common in 5- and 6-year olds and in 10- and 11-year olds, it occurs more frequently during major changes in a child’s life, such as entrance to kindergarten, changing from elementary to middle school, or changing from middle to high school. The problem may start following vacations, school holidays, summer vacation, or brief illness, after the child has been home for some time, and usually ends prior to vacations, school holidays, or summer vacation, before the child will be out of school for some time. School refusal can also occur after a stressful event, such as moving to a new house, or the death of a pet or relative.
The rate is similar within both genders, and although it is significantly more prevalent in some urban areas, there are no known socioeconomic differences.
Discomfort from separations in children from ages 8 to 14 months is normal. Children oftentimes get nervous or afraid of unfamiliar people and places but if the behavior still occurs after the age of 6 and if it lasts longer than four weeks, the child might have Separation Anxiety Disorder.
About 4% of children have the disorder. Separation Anxiety Disorder is very treatable especially when caught early on with medication and behavioral therapies. Helping children with separation anxiety to identify the circumstances that elicit their anxiety (upcoming separation events) is important. A child's ability to tolerate separations should gradually increase over time when he or she is gradually exposed to the feared events. Encouraging a child with separation anxiety disorder to feel competent and empowered, as well as to discuss feelings associated with anxiety-provoking events promotes recovery.
Children with separation anxiety disorder often respond negatively to perceived anxiety in their caretakers, in that parents and caregivers who also have anxiety disorders may unwittingly confirm a child's unrealistic fears that something terrible may happen if they are separated from each other. Thus, it is critical that parents and caretakers become aware of their own feelings and communicate a sense of safety and confidence about separation.
Anxiety disorders are the most common type of psychopathology to occur in today's youth, affecting from 5–25% of children worldwide. Of these anxiety disorders, SAD accounts for a large proportion of diagnoses. SAD may account for up to 50% of the anxiety disorders as recorded in referrals for mental health treatment. SAD is noted as one of the earliest-occurring of all anxiety disorders. Adult separation anxiety disorder affects roughly 7% of adults. It has also been reported that the clinically anxious pediatric population are considerably larger. For example, according to Hammerness et al. (2008) SAD accounted for 49% of admissions.
Research suggests that 4.1% of children will experience a clinical level of separation anxiety. Of that 4.1% it is calculated that nearly a third of all cases will persist into adulthood if left untreated. Research continues to explore the implications that early dispositions of SAD in childhood may serve as risk factors for the development of mental disorders throughout adolescence and adulthood. It is presumed that a much higher percentage of children suffer from a small amount of separation anxiety, and are not actually diagnosed. Multiple studies have found higher rates of SAD in girls than in boys, and that paternal absence may increase the chances of SAD in girls.
Many people report stress-induced speech disorders which are only present during public speech. Some individuals with glossophobia have been able to dance, perform in public, or even to speak (such as in a play), or sing if they cannot see the audience, or if they feel that they are presenting a character or stage persona other than themselves. Being able to blend in a group (as in a choir or band) has been reported to also alleviate some anxiety caused by glossophobia.
It has been estimated that 75% of all people experience some degree of anxiety/nervousness when it comes to public speaking. In fact, surveys have shown that most people fear public speaking more than they fear death. If untreated, public speaking anxiety can lead to serious detrimental effects on one's quality of life, career goals and other areas. For example, educational goals requiring public speaking might be left unaccomplished. However, not all persons with public speaking anxiety are necessarily unable to achieve work goals, though this disorder becomes problematic when it prevents an individual from attaining or pursuing a goal they might otherwise have - were it not for their anxiety.
A recent study conducted by Garcia-Lopez, Diez-Bedmar, and Almansa-Moreno (2013) has reported that previously trained students could act as trainers to other students and help them to improve their public speaking skills.
Typically, this disease is presaged by a childhood history of social inhibition and shyness. It is possible that it could result from a humiliating traumatic experience, or it could emerge from a lifelong onset of the illness that only comes to the surface after time.
Clinical data indicates that more males have the condition than females, despite the fact that females scored higher on a social phobia scale than men, and report higher scores on proclivity towards feelings of embarrassment. This differs from Western society where the prevalence of females with social phobias is to some extent greater than that of males. The lifetime prevalence of the disorder falls anywhere between 3% and 13% with changes in severity occurring throughout one's lifetime. It is estimated that about 17% of individuals with taijin kyofusho have fears of releasing foul body odor.
Social anxiety disorder is known to appear at an early age in most cases. Fifty percent of those who develop this disorder have developed it by the age of 11, and 80% have developed it by age 20. This early age of onset may lead to people with social anxiety disorder being particularly vulnerable to depressive illnesses, drug abuse and other psychological conflicts.
When prevalence estimates were based on the examination of psychiatric clinic samples, social anxiety disorder was thought to be a relatively rare disorder. The opposite was found to be true; social anxiety was common, but many were afraid to seek psychiatric help, leading to an underrecognition of the problem.
The National Comorbidity Survey of over 8,000 American correspondents in 1994 revealed 12-month and lifetime prevalence rates of 7.9 percent and 13.3 percent, respectively; this makes it the third most prevalent psychiatric disorder after depression and alcohol dependence, and the most common of the anxiety disorders. According to U.S. epidemiological data from the National Institute of Mental Health, social phobia affects 15 million adult Americans in any given year. Estimates vary within 2 percent and 7 percent of the U.S. adult population.
The mean onset of social phobia is 10 to 13 years. Onset after age 25 is rare and is typically preceded by panic disorder or major depression. Social anxiety disorder occurs more often in females than males. The prevalence of social phobia appears to be increasing among white, married, and well-educated individuals. As a group, those with generalized social phobia are less likely to graduate from high school and are more likely to rely on government financial assistance or have poverty-level salaries. Surveys carried out in 2002 show the youth of England, Scotland, and Wales have a prevalence rate of 0.4 percent, 1.8 percent, and 0.6 percent, respectively. In Canada, the prevalence of self-reported social anxiety for Nova Scotians older than 14 years was 4.2 percent in June 2004 with women (4.6 percent) reporting more than men (3.8 percent). In Australia, social phobia is the 8th and 5th leading disease or illness for males and females between 15–24 years of age as of 2003. Because of the difficulty in separating social phobia from poor social skills or shyness, some studies have a large range of prevalence. The table also shows higher prevalence in Sweden.
It is during the years of young adulthood (20 to 40 years of age) that death anxiety most often begins to become prevalent. However, during the next phase of life, the middle age adult years (40–64 years of age), death anxiety peaks at its highest levels when in comparison to all other age ranges throughout the lifespan. Surprisingly, levels of death anxiety then slump off in the old age years of adulthood (65 years of age and older). This is in contrast with most people’s expectations, especially regarding all of the negative connotations younger adults have about the elderly and the aging process (Kurlychek & Trenner, 1982).
The telephone is important for both contacting others and accessing important and useful services. As a result, this phobia causes a great deal of stress and impacts people's personal lives, work lives and social lives. Sufferers avoid many activities, such as scheduling events or clarifying information. Strain is created in the workplace because use of phones may play a crucial role within a career.
Fear of intimacy is generally a social phobia and anxiety disorder resulting in difficulty forming close relationships with another person. The term can also refer to a scale on a psychometric test, or a type of adult in attachment theory psychology.
The fear of intimacy is the fear of being emotionally and/or physically close to another individual. This fear is also defined as “the inhibited capacity of an individual, because of anxiety, to exchange thought and feelings of personal significance with another individual who is highly valued”. Fear of intimacy is the expression of existential views in that to love and to be loved makes life seem precious and death more inevitable. It often results from past traumas such as rape or childhood sexual abuse. Fear of intimacy is also related to the fear of being touched .
It has been shown that there is a two to threefold greater risk of having social phobia if a first-degree relative also has the disorder. This could be due to genetics and/or due to children acquiring social fears and avoidance through processes of observational learning or parental psychosocial education. Studies of identical twins brought up (via adoption) in different families have indicated that, if one twin developed social anxiety disorder, then the other was between 30 percent and 50 percent more likely than average to also develop the disorder. To some extent this 'heritability' may not be specific – for example, studies have found that if a parent has any kind of anxiety disorder or clinical depression, then a child is somewhat more likely to develop an anxiety disorder or social phobia. Studies suggest that parents of those with social anxiety disorder tend to be more socially isolated themselves (Bruch and Heimberg, 1994; Caster et al., 1999), and shyness in adoptive parents is significantly correlated with shyness in adopted children (Daniels and Plomin, 1985).
Growing up with overprotective and hypercritical parents has also been associated with social anxiety disorder. Adolescents who were rated as having an insecure (anxious-ambivalent) attachment with their mother as infants were twice as likely to develop anxiety disorders by late adolescence, including social phobia.
A related line of research has investigated 'behavioural inhibition' in infants – early signs of an inhibited and introspective or fearful nature. Studies have shown that around 10–15 percent of individuals show this early temperament, which appears to be partly due to genetics. Some continue to show this trait into adolescence and adulthood, and appear to be more likely to develop social anxiety disorder.
Agoraphobia occurs about twice as commonly among women as it does in men. The gender difference may be attributable to several factors: sociocultural traditions that encourage, or permit, the greater expression of avoidance coping strategies by women (including dependent and helpless behaviors), women perhaps being more likely to seek help and therefore be diagnosed, and men being more likely to abuse alcohol in reaction to anxiety and be diagnosed as an alcoholic. Research has not yet produced a single clear explanation for the gender difference in agoraphobia.
Panic disorder with or without agoraphobia affects roughly 5.1% of Americans, and about 1/3 of this population with panic disorder have comorbid agoraphobia. It is uncommon to have agoraphobia without panic attacks, with only 0.17% of people with agorophobia not presenting panic disorders as well.
People with this fear are anxious about or afraid of intimate relationships. They believe that they do not deserve love or support from others. Fear of intimacy has three defining features: content which represents the ability to communicate personal information, emotional valence which refers to the feelings about personal information exchanged, and vulnerability signifying their regard for the person they are intimate with. Bartholomew and Horowitz go further and determine four different adult attachment types: “(1) Secure individuals have a sense of worthiness or lovability and are comfortable with intimacy and autonomy; (2) preoccupied persons lack this sense of self-worthiness yet view others positively and seek their love and acceptance; (3) fearful people lack a sense of lovability and are avoidant of others in anticipation of rejection; (4) dismissing persons feel worthy of love yet detach from others whom they generally regard as untrustworthy”.
A study on comorbidity of GAD and other depressive disorders has shown that treatment is not more or less effective when there is some sort of comorbidity of another disorder. The severity of symptoms did not affect the outcome of the treatment process in these cases.
Glossophobia or speech anxiety is the fear of public speaking. The word "glossophobia" derives from the Greek γλῶσσα "glōssa", meaning tongue, and φόβος "phobos", fear or dread. Some people have this specific phobia, while others may also have broader social phobia or social anxiety disorder.
Stage fright may be a symptom of glossophobia.
Though scopophobia is a solitary disorder, many individuals with scopophobia also commonly experience other anxiety disorders. Scopophobia has been related to many other irrational fears and phobias. Specific phobias and syndromes that are similar to scopophobia include erythrophobia, the fear of blushing (which is found especially in young people), and an epileptic's fear that being looked which may itself precipitate such an attack. Scopophobia is also commonly associated with schizophrenia and other psychiatric disorders. It is not considered indicative of other disorders, but is rather considered as a psychological problem that may be treated independently.
Sociologist Erving Goffman suggested that shying away from casual glances in the street remained one of the characteristic symptoms of psychosis in public. Many scopophobia patients develop habits of voyeurism or exhibitionism. Another related, yet very different syndrome, scopophilia, is the excessive enjoyment of looking at erotic items.
Hypochondria is currently considered a psychosomatic disorder, as in a mental illness with physical symptoms. Cyberchondria is a colloquial term for hypochondria in individuals who have researched medical conditions on the Internet. The media and the Internet often contribute to hypochondria, as articles, TV shows and advertisements regarding serious illnesses such as cancer and multiple sclerosis often portray these diseases as being random, obscure and somewhat inevitable. Inaccurate portrayal of risk and the identification of non-specific symptoms as signs of serious illness contribute to exacerbating the hypochondriac’s fear that they actually have that illness.
Major disease outbreaks or predicted pandemics can also contribute to hypochondria. Statistics regarding certain illnesses, such as cancer, will give hypochondriacs the illusion that they are more likely to develop the disease.
Overly protective caregivers and an excessive focus on minor health concerns have been implicated as a potential cause of hypochondriasis development.
It is common for serious illnesses or deaths of family members or friends to trigger hypochondria in certain individuals. Similarly, when approaching the age of a parent's premature death from disease, many otherwise healthy, happy individuals fall prey to hypochondria. These individuals believe they are suffering from the same disease that caused their parent's death, sometimes causing panic attacks with corresponding symptoms.
Family studies of hypochondriasis do not show a genetic transmission of the disorder. Among relatives of people suffering from hypochondriasis only somatization disorder and generalized anxiety disorder were more common than in average families. Other studies have shown that the first degree relatives of patients with OCD have a higher than expected frequency of a somatoform disorder (either hypochondriasis or body dysmorphic disorder).
Stranger anxiety is a form of distress that children experience when exposed to people unfamiliar to them. Symptoms may include: getting quiet and staring at the stranger, verbally protesting by cries or other vocalizations, and hiding behind a parent. Stranger anxiety is a typical part of the developmental sequence that most children experience. It can occur even if the child is with a caregiver or another person they trust.
It peaks from 6 to 12 months
Nomophobia occurs in situations when an individual experiences anxiety due to the fear of not having access to a mobile phone. The "over-connection syndrome" occurs when mobile phone use reduces the amount of face-to-face interactions thereby interfering significantly with an individual’s social and family interactions. The term "techno-stress" is another way to describe an individual who avoids face-to-face interactions by engaging in isolation including psychological mood disorders such as depression.
Anxiety is provoked by several factors, such as the loss of a mobile phone, loss of reception, and a dead mobile phone battery. Some clinical characteristics of nomophobia include using the device impulsively, as a protection from social communication, or as a transitional object. Observed behaviors include having one or more devices with access to internet, always carrying a charger, and experiencing feelings of anxiety when thinking about losing the mobile.
Other clinical characteristics of nomophobia are a considerably decreased number of face-to-face interactions with humans, replaced by a growing preference for communication through technological interfaces, keeping the device in reach when sleeping and never turned off, and looking at the phone screen frequently to avoid missing any message, phone call, or notification (also called ringxiety). Nomophobia can also lead to an increase of debt due to the excessive use of data and the different devices the person can have. Nomophobia may also lead to physical issues such as sore elbows, hands, and necks due to repetitive use.
Irrational reactions and extreme reactions due to anxiety and stress may be experienced by the individual in public settings where mobile phone use is restricted, such as in airports, academic institutions, hospitals and work. Overusing a mobile phone for day-to-day activities such as purchasing items can cause the individual financial problems. Signs of distress and depression occur when the individual does not receive any contact through a mobile phone. Attachment signs of a mobile phone also include the urge to sleep with a mobile phone. The ability to communicate through a mobile phone gives the individual peace of mind and security.
Nomophobia may act as a proxy to other disorders. Those suffering from an underlying social disorder are likely to experience nervousness, anxiety, anguish, perspiration, and trembling when separated or unable to use their digital devices due to low battery, out of service area, no connection, etc. Such people will often insist on keeping their devices on hand at all times, typically returning to their homes to retrieve forgotten cell phones.
Nomophobic behavior may reinforce social anxiety tendencies and dependency on using virtual and digital communications as a method of reducing stress generated by social anxiety and social phobia. Those suffering from panic disorders may also show nomophobic behavior, however, they will probably report feelings of rejection, loneliness, insecurity, and low self-esteem in regard to their cell phones, especially when times with little to no contact (few incoming calls and messages). Those with panic disorder will probably feel significantly more anxious and depressed with their cellphone use. Despite this, those suffering from panic disorder were significantly less likely to place voice calls.
The prognosis varies on the severity of each case and utilization of treatment for each individual.
If these children are left untreated, they face risks such as poor results at school, avoidance of important social activities, and substance abuse. Children who have an anxiety disorder are likely to have other disorders such as depression, eating disorders, attention deficit disorders both hyperactive and inattentive.
Stranger anxiety develops slowly, it does not just appear suddenly. It typically first starts to appear around 4 months of age with infants behaving differently with caregivers than with strangers. They become cautious when strangers are around. Around 7-8 months infants become more aware of their surroundings, so stranger anxiety is more frequent and clearly displayed. As a child’s cognitive skills develop and improve, typically around 12 months, their stranger anxiety can become more intense. They display behaviors like running to their caregiver, grabbing at the caregiver’s legs, or demanding to be picked up.
One cause of separation anxiety in canines is chronic stress. A study in 2012 tested nelumbinis semen, the seeds of the herb "Nelumbo nucifera", and its anti-depressant effects on animals experiencing stress. It should be noted that this study did not test directly on canines, but rather rats, and aimed to apply the principles found by the study to other animals such as dogs. The study, however, did test oral toxicity specifically on canines. After testing different dosage amounts of the nelumbinis semen, scientists determined that 400 mg per the animal's weight in kilograms was the most ideal amount to lower immobility when the animal was faced with a stressful situation. In addition, nelumbinis semen was not found toxic when administered to dogs. Based on these findings, it is possible that if more research was put into studying herbal remedies such as nelumbinis semen, it is possible that alternative and "natural" ingredients could be used as a substitute for drug-based therapy.
The connection between death anxiety and one's sex appears to be strong. Studies show that females tend to have more death anxiety than males. Thorson and Powell (1984) did a study to investigate this connection, and they sampled men and women from 16 years of age to over 60. The Death Anxiety Scale showed higher mean scores for women than for men. Moreover, researchers believe that age and culture could be major influences in why women score higher on death anxiety scales than men.
Through the evolutionary period, a basic method was created to deal with death anxiety and also as a means of dealing with loss. Denial is used when memories or feelings are too painful to accept and are often rejected. By maintaining that the event never happened, rather than accepting it, allows an individual more time to work through the inevitable pain. When a loved one dies in a family, denial is often implemented as a means to come to grips with the reality that the person is gone. Closer families often deal with death better than when coping individually. As society and families drift apart so does the time spent bereaving those who have died, which in turn leads to negative emotion and negativity towards death. Women, who are the child bearers and are often the ones who look after children hold greater concerns about death due to their caring role within the family. It is this common role of women that leads to greater death anxiety as it emphasize the ‘importance to live’ for her offspring. Although it is common knowledge that all living creatures die, many people do not accept their own mortality, preferring not to accept that death is inevitable, and that they will one day die.
The cause of dog separation anxiety is unknown, but may be triggered by:
- a traumatic event
- a change in routine
- major life change (e.g., new home, new baby, death of a family member, abandonment to a shelter)
- extreme attachment or dependency on the owner